Claims Customer Service Representative

Claims Customer Service Representative

Insurance Administrative Solutions

Clearwater, FL

About Insurance Administrative Solutions

Insurance Administrative Solutions (IAS) is a third-party provider of comprehensive administrative solutions for our clients in the insurance industry. We offer a business process outsourcing solution that helps insurers optimize administrative workload, bolster their industry
expertise, leverage emerging technologies, and streamline operations. With strong industry knowledge, we deliver value to our customers by providing compassionate customer service, efficient processing, and quality results. Here at IAS, we embrace the fact that great things are only accomplished by working as a team. We believe that all of our employees have valuable input no matter the level. Our highly collaborative team environment offers each of our employees a place where they can excel.

Job Summary

Examine, perform, research and make the decisions necessary to properly adjudicate telephone and written inquiries. Interpret contract benefits in accordance with specific claims processing guidelines. Communicate problems identified relevant to the claims processing system to the appropriate people. Receive, organize and make daily use of information regarding benefits, contract coverage, and policy decisions. Maintain external contacts with policyholders, providers of service, agents, attorneys and other carriers as well as internal contacts with peers, management, and other support areas with a positive and professional approach.

Primary Responsibilities: 

• Interpret contract benefits accurately to policyholder, agents, and providers with a positive and professional approach.

• Provide claim status to policyholders or providers with a positive and professional approach.

• Send out refund request letters and follow-up as necessary.

• Produce correspondence to customers.

• Answer calls as required by company policy in a helpful, professional, timely manner.

• Place outgoing calls as needed to provide or obtain information.

• Document (written/on-line) all calls while in progress. 

• Transfer calls to employees in other departments as required to meet customer needs.

• Fully document policy file or imaging system with all related material so as to leave a clear and concise audit trail.

• Actively participate in cross training and group training sessions to maximize team efficiency and maintain or exceed service standards.

• Communicate openly with Supervisor, Team Lead and other team members to ensure accurate responses and avoid duplication of efforts.

Primary Skills & Requirements:  

• High School Diploma or GED equivalent

• Minimum of one (1) year related experience in a fast-paced call center required.  

• Experience in medical/insurance preferred.  

• Experience with Medicare Supplement preferred.

• May have agent license but no active appointments.

• Must be local or residing in the nearby area.

Schedule:

• Monday to Friday

• 37 hour work week

About Integrity

Integrity is one of the nation’s leading independent distributors of life, health and wealth insurance products. With a strong insurtech focus, we embrace a broad and innovative approach to serving agents and clients alike. Integrity is driven by a singular purpose: to help people protect their life, health and wealth so they can prepare for the good days ahead.

Integrity offers you the opportunity to start a career in a family-like environment that is rewarding and cutting edge. Why? Because we put our people first! At Integrity, you can start a new career path at company you’ll love, and we’ll love you back. We’re proud of the work we do and the culture we’ve built, where we celebrate your hard work and support you daily. Joining us means being part of a hyper-growth company with tons of professional opportunities for you to accelerate your career. Integrity offers our people a competitive compensation package, including benefits that make work more fun and give you and your family peace of mind. 

Headquartered in Dallas, Texas, Integrity is committed to meeting Americans wherever they are — in person, over the phone or online. Integrity’s employees support hundreds of thousands of independent agents who serve the needs of millions of clients nationwide. For more information, visit Integrity.com.

Integrity, LLC is an Equal Opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, gender identity, national origin, disability, veteran status, or any other characteristic protected by federal, state, or local law. In addition, Integrity, LLC will provide reasonable accommodations for qualified individuals with disabilities.